Horizon Blog

In September 2016, the American Psychiatric Association announced a number of changes to the International Classification of Diseases, Tenth Edition (ICD-10). These changes were made to reflect the updated diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s classification and diagnostic reference.

While the new codes are supposed to allow for more accurate diagnostic recording, improved communication among clinicians, and better means for collecting prevalence data, there is still controversy in the medical community about the changes published in DSM-5, the first update of the DSM since 1994.

One of the most highly debated changes included the elimination of Asperger’s disorder and the grouping all of the subcategories of autism into a single category known as autism spectrum disorder (ASD). This created what critics call a “sliding scale” for autism, meaning individuals will be diagnosed somewhere along the autism spectrum, which raised concerns that some people already diagnosed with an autism disorder, like Asperger’s or PDD-NOS, will be excluded. Those who praise the change say it will further refine the way providers diagnose autism, allowing them to account for individual differences rather than trying to generalize patients into one of four categories.

Another controversy was the elimination of pediatric bipolar disorder and the addition of a new category called disruptive mood dysregulation disorder (DMDD), described as intense outbursts and irritability beyond normal temper tantrums in young children. This was most likely done in response to an increase in bipolar disorder diagnoses in very young children, who were then put on powerful antipsychotic medications. Some clinicians worry that the category will be applied too liberally.

The DSM’s chapter on substance abuse has been retitled the Substance Use Disorders chapter. The diagnostic criteria for such conditions have been expanded, and two seemingly similar words have been swapped: the term “dependence” is out and the term “addiction” is in. Additionally, there are two new controversial categories in the DSM-5: gambling disorders and cannabis withdrawal. Substance use disorders will also be categorized more on a sliding scale, depending on the severity of each patient’s symptoms.

The less controversial changes include refining the criteria for post-traumatic stress disorders (PTSD) and including a subtype for PTSD in preschool children, and revising the diagnosis for attention deficit hyperactivity disorder with the elimination of a previously required symptom and the changing of the required age of onset from age 7 to age 12.

At Horizon Health Services, we are always working to find the best diagnoses and solutions for the people we work with. We help individuals and families struggling with mental health and substance use disorders including PTSD, depression, and alcohol dependence. If you are looking for answers and support, please call us at (716) 831-1800. Horizon Health Services can help.